A Phase I/IIa Safety Study of Subretinal Implantation of CPCB-RPE1 (Human Embryonic Stem Cell-Derived Retinal Pigment Epithelial Cells Seeded on a Polymeric Substrate) in Subjects With Advanced, Dry Age-Related Macular Degeneration (AMD)
Overview
- Phase
- Phase 1
- Intervention
- Not specified
- Conditions
- Dry Macular Degeneration
- Sponsor
- Regenerative Patch Technologies, LLC
- Enrollment
- 16
- Locations
- 6
- Primary Endpoint
- Frequency and Severity of Treatment-Related Adverse Events [Safety and Tolerability]
- Last Updated
- 5 years ago
Overview
Brief Summary
The Phase I/IIa clinical trial is designed to assess the feasibility of delivery and safety of Human Embryonic Stem Cell-Derived RPE Cells on a parylene membrane (CPCB-RPE1) in patients with advanced, dry age-related macular degeneration.
Primary Objective:
• To test the safety and tolerability of CPCB-RPE1 during and after subretinal implantation in patients with geographic atrophy with evidence of involvement of the central fovea.
Secondary Objective:
• To assess visual acuity, visual field, and retinal function after CPCB-RPE1 implantation. Implanted and fellow eyes will be compared post-implantation to assess the ability of the implant to prevent disease progression.
Exploratory Objectives:
• To assess the feasibility of measuring the change in area of geographic atrophy over time using spectral domain optical coherence tomography or fundus autofluorescence.
Detailed Description
The study will include two cohorts, each of 10 patients. For the first cohort, the study population will be patients with advanced, dry AMD with evidence of significant geographic atrophy involving the fovea. These patients will have significant central vision loss with best-corrected visual acuity (BCVA) of the eye to be implanted of BCVA of 20/200 or worse. Each of these patients will have substantial RPE and photoreceptor loss. Patients will be screened for overall health status to minimize risks associated with retinal surgery and any subsequent immunosuppression. As the safety and tolerability of CPCB-RPE1 is demonstrated in the first cohort, patients with less advanced disease will be recruited into a second cohort in this Phase I/IIa clinical trial. In this second cohort patients will have significant central vision loss with BCVA of the eye to be implanted of 20/80 or worse, but better than or equal to 20/400 with comparably less damage to the RPE/photoreceptor complex than Cohort 1. These patients will be screened in the same manner for overall health status to minimize risks associated with retinal surgery and any subsequent immunosuppression. Assessments of visual function will be the same as in Cohort 1.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Patients able to understand and willing to sign the informed consent
- •Adult male or female patients with the age of 55 to 85 (inclusive) years who are not employees of the trial sites
- •In sufficiently good health to reasonably expect survival for at least five years after treatment
- •Clinical findings consistent with advanced dry AMD with evidence of one or more areas of ≥1.25 square millimeter of geographic atrophy involving the central fovea
- •Geographic atrophy defined as attenuation or loss of RPE as observed by biomicroscopy, OCT, or FAF
- •The best-corrected visual acuity (BCVA) of the eye to receive the implant will be equal or worse than 20/200 in the first half of the study patients and between 20/80 and 20/400 (inclusive) in the second half of the patients. The BCVA of the eye that is NOT to receive the implant will be better or equal to the eye that will receive the implant
- •Medically suitable to undergo pars plana vitrectomy and the surgical implant procedure, including being able to position post-operatively and use post-operative medications as required
- •Medically suitable for general anesthesia or monitored intravenous sedation, if needed
- •Patients who are pseudophakic or aphakic in the study eye
- •If designated as an organ donor, willing to forego live organ donation
Exclusion Criteria
- •Presence of active or inactive choroidal neovascularization (CNV)
- •Presence or history of retinal dystrophy, retinitis pigmentosa, chorioretinitis, central serous choroidopathy or any other inflammatory ocular disease except dry eye syndrome
- •Presence or history of severe, end-stage corneal dystrophy
- •History of steroid induced ocular hypertension or glaucoma
- •Presence of moderate to severe glaucomatous optic neuropathy in the study eye, uncontrolled IOP, use of two or more topical agents to control intraocular pressure; history of glaucoma-filtering surgery
- •Presence of moderate to severe non-proliferative diabetic retinopathy in the study eye
- •Presence of any proliferative diabetic retinopathy in the study eye
- •Presence of uncontrolled diabetes mellitus (HbA1c \> 8) at the time of screening
- •History of retinal detachment or retinal detachment repair in the study eye other than peripheral retinal tears or holes treated exclusively with laser or cryotherapy
- •Presence of any other sight-threatening ocular disease
Outcomes
Primary Outcomes
Frequency and Severity of Treatment-Related Adverse Events [Safety and Tolerability]
Time Frame: 1 year
Comparison of product, procedure and immunosuppression related adverse events in the implanted eye to those experienced in the non-treated eye
Secondary Outcomes
- Photoreceptor Electrical Responses(1 year)
- Visual Acuity(1 year)
- Visual Field(1 year)